Aetna -Alabama

One of the many great plans in Alabama comes from our good friends at Aetna health insuance.  Though not always priced the best in Alabama, Aetna is by far the most trusted name in health insurance to me.  Why?  Because they never rescind policies number and number two they take human beings, with all of flaws, medications, warts etc.  They will accept even diabetics in many cases and they are the only Alabama company besides AARP (which is underwritten by Aetna of course) to accept them.

Aetna Health Insurance Plans Option In Alabama

Aetna Alabama Health Insurance Plans

The Aetna  health insurance plans are designed to offer you quality coverage in Alabama at an excellent value. Coverage can include prescription drugs, doctor visits, hospitalization and preventive care services.

Generally speaking, the lower your “premiums,” or monthly payments, the higher your “deductible,” which is the amount you pay out of pocket before the plan begins paying for expenses.

You’ll pay less by using “in-network” doctors, hospitals, pharmacies and other health care providers who participate in Aetna’s nationwide network than by using “out-of-network” doctors.

Plans at a Glance in Alabama

Here are Aetna’s* plans for individuals in your state. Just click on “more” to learn more about any of them.
PPO High-Deductible 3000

(HSA Compatible)

PPO High-Deductible 5000

(HSA Compatible)

Lower contributions. Moderately high deductible, then pay 0% of fee for most visits and services. Allows you to open a tax-advantaged HSA.** Lower contributions. High deductible, then no charge for most visits and services. Allows you to open a tax-advantaged HSA.**
First Dollar 30 First Dollar 40
Moderate premiums, moderate out-of-pocket maximum and quality prescription drug coverage. Moderate premiums, moderate out-of-pocket maximum and quality prescription drug coverage.
PPO 1000 PPO 2500
Lower deductibles, copays and expenses, moderately higher premiums. Quality prescription coverage. Lower deductibles, copays and expenses, moderately higher premiums. Quality prescription coverage.
PPO 5000 PPO Value 2500
Lower deductibles, copays and expenses, moderately higher premiums. Quality prescription coverage. Moderate balance of plan features and affordable monthly premiums.
Preventive and Hospital Care 1250 Preventive and Hospital Care 3000
(HSA Compatible)
Low premiums, low annual deductible and moderately high out-of-pocket maximum. Low premiums, moderate annual deductible and high out-of-pocket maximum.
PPO 7500 with Unlimited Primary Care Visits plus Dental
Lower premiums, moderately higher copays, deductible and out-of-pocket maximum.

Aetna Alabama Rate Breakdowns

In Alabama your premium is not only determined by your age but of course your rates will depend on the area in which your county is located.  For more information or a quote on what your rate would be, call us at 888 803 5917 or fill out our Aetna health insurance quote.  But here is how the rates are broken down in Aetna.

Area 1 Counties

Autauga Elmore Monroe
Baldwin Escambia Montgomery
Bullock Hale Perry
Chambers Lee Russell
Clarke Lowndes Washington
Crenshaw Macon Wilcox
Dallas Mobile
Area 2 Counties
Bibb Etowah Morgan
Blount Fayette Saint Clair
Calhoun Jackson Shelby
Cherokee Jefferson Talladega
Chilton Lawrence Tallapoosa
Clay Limestone Walker
Cleburne Madison Winston
Coosa Marion
De Kalb Marshall
Area 3 Counties

Barbour Dale Marengo Butler Franklin Pickens Choctaw Geneva Pike Coffee Greene Randolph Colbert Henry Sumter Conecuh Houston Tuscaloosa Covington Lamar Cullman Lauderdale

Things you need to know

To qualify for an Aetna Advantage Plan, you must be:

  • Under age 64 3/4 (If applying as a couple, both you and your spouse must be under 64 3/4.)
  • Unmarried dependent children up to age 19 n Age 19 to 23 with proof of full-time student status
  • Legal residents in a state with products offered by the Aetna Advantage Plans n Legal U.S. residents for at least six continuous months

Your premium payments

Your rates are guaranteed not to increase for 12 months from your effective date once you’ve been accepted for coverage. After that, your premiums may change. Final rates are subject to underwriting review.

Your coverage

Your coverage remains in effect as long as you pay the required premium charges on time, and as long as you maintain eligibility in the plan. Coverage will be terminated if you become ineligible due to any of the following circumstances:

  • Non-payment of premiums
  • Becoming a resident of a state or location in which Aetna Advantage Plans are not available
  • Obtaining duplicate coverage
  • For other reasons permissible by law

Discount programs provide access to discounted prices and are NOT insured benefits.

EASY-PAY

simple Automatic payments via electronic funds transfer (eft)

Registration: Complete the payment section of the Aetna Advantage Plans application. Select the EFT option to approve the automatic withdrawal of your initial premium and all subsequent premium payments.

Invoices: You will not receive a paper invoice when you are enrolled in EFT. Payments will appear on your bank statement as “Aetna Autodebit Coverage.”

Terminating: To terminate EFT, you will need to provide Aetna with 10 days written notice prior to the date your next EFT payment will be deducted. Without this written notice, your bank account may be debited for the next month’s premium. You will then need to contact Aetna to have funds placed back in the checking account.

Refunds: To process an EFT refund (placing money back in member’s checking account), Aetna will require at least five days after the withdrawal was made to ensure valid payment.

Rejected transactions: If the EFT payment rejects for any reason, Aetna will automatically terminate the EFT and send you a letter saying you will receive paper invoices. Processing time to reinstate EFT will be 30–60 days. If an EFT payment is rejected, you will need to pay that payment by paper check or credit card.

Timing: Payments for Cycle 1 accounts (1st of the month effective date) will be taken from your bank account between the 3rd and the 10th of the month the premium is due. Payments for Cycle 2 accounts (15th of the month effective date) will be taken from your bank account between the 18th and 23rd of the month the premium is due.

Levels of coverage & enrollment

  • You may be enrolled in your selected plan at the premium charge.
  • You may be enrolled in your selected plan at a higher premium, based on medical underwriting.
  • You may be declined coverage based on medical underwriting.

Medical underwriting requirements

The Aetna Advantage Plans are not guaranteed issue plans and require medical underwriting. Some individuals may qualify as federally eligible under the Health Insurance Portability Accountability Act (HIPAA) through the Alabama Health Insurance Plan (AHIP)

All applicants, enrolling spouses and dependents are subject to medical underwriting to determine eligibility and appropriate premium rate level.

We offer various premium rate levels based on the medical underwriting of each applicant.

10-day right to review

Do not cancel your current insurance until you are notified that you have been accepted for coverage. We’ll review your application to determine if you meet underwriting requirements. If you’re denied, you’ll be notified by mail. If you’re approved, you’ll be sent an Aetna Advantage Plan contract and ID card.

If, after reviewing the contract, you find that you’re not satisfied for any reason, simply return the contract to us within 10 days. We will refund any premium you’ve paid (including any contract fees or other charges) less the cost of any services paid on behalf of you or any covered dependent.

Duplicate coverage

If you are currently covered by another carrier, you must agree to discontinue the other coverage before or on the effective date of the Aetna Advantage Plan. Do not cancel your current insurance until you are notified that you have been accepted for coverage and are certain that you are keeping your Aetna Advantage Plan coverage.

Alabama Limitations & Exclusions

Medical Exclusions

These medical plans do not cover all health care expenses and include exclusions and limitations. You should refer to your plan documents to determine which health care services are covered and to what extent.

The following is a partial list of services and supplies that are generally not covered. However, your plan documents may contain exceptions to this list based on state mandates or the plan design or rider(s). Services and supplies that are generally not covered include, but are not limited to:

All medical and hospital services not specifically covered in, or which are limited or excluded by your plan documents, including costs of services before coverage begins and after coverage terminates

  • Ambulance coverage is limited to $1,000 per trip
  • Cosmetic surgery
  • Custodial care
  • Donor egg retrieval
  • Weight control services including surgical procedures for the treatment of obesity, medical treatment, and weight control/loss programs
  • Experimental and investigational procedures, (except for coverage for medically necessary routine patient care costs for Members participating in a cancer clinical trial)
  • Charges in connection with pregnancy care other than for pregnancy complications
  • Immunizations for travel or work
  • Implantable drugs and certain injectable drugs including injectable infertility drugs
  • Infertility services including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI and other related services unless specifically listed as covered in your plan documents
  • Non-medically necessary services or supplies
  • Orthotics
  • Over-the-counter medications and supplies
  • Radial keratotomy or related procedures
  • Reversal of sterilization
  • Services for the treatment of sexual dysfunction or inadequacies including therapy, supplies or counseling
  • pre-existing Conditions
  • During the first 12 months following your effective date of coverage, no coverage will be provided for the treatment of a pre-existing condition unless you have prior creditable coverage.
  • A preexisting condition is an illness, disease, physical condition, or injury for which medical advice, or treatment was recommended or received and/or the use of prescription drugs of any kind within six months preceding the effective date of coverage. Services or supplies for the treatment of a preexisting condition are not covered for the first 12 months after the member s effective date. If the member had continuous prior creditable coverage within the 63 days immediately preceding the signature on the application and meets certain other requirements, then the preexisting condition exclusion of 12 months may not apply.
  • Special or private duty nursing
  • Therapy or rehabilitation other than those listed as covered in the plan documents
  • Chemical dependency and substance abuse not covered
  • Mental health services for PPO plans not covered
  • Dental